While standard postpartum screening is vital, Alexis Totaro emphasises the importance of careful clinical assessment and input from loved ones to detect subtle early signs of mental health issues in new mothers.
Standard screening for postpartum depression and psychosis matters, but it cannot replace a careful clinical examination, Alexis Totaro, MSN, RN, WHNP-c, CARN-AP, said in an interview with Contemporary OB/GYN. Totaro, vice president of mental health operations and chief nurse executive at Christian Health, said the first warning signs are often small changes from a patient’s usual behaviour, rather than obvious distress.
Those changes can include muddled communication, sentences that do not flow coherently, social withdrawal, agitation, neglect of hygiene, or shifts in the tone and pace of speech. Totaro said clinicians should also pay attention to whether a patient seems to handle infant care in an unusually mechanical way. Because many patients are able to mask symptoms, she said input from family members and friends who know the person well can be essential in spotting when something is wrong.
Sleep can offer another clue. Totaro said ordinary newborn-related sleep loss usually looks like exhaustion, with a parent able to sleep when given the chance and feeling better afterwards. By contrast, emerging postpartum depression or anxiety may involve persistent, unwanted and intrusive thoughts, constant worry about the baby, and an inability to settle even when rest is available. Mayo Clinic and Cleveland Clinic both note that postpartum depression is more than the brief “baby blues” and can require prompt medical attention.
Other health sources point to warning signs that can intensify quickly, including severe insomnia, racing thoughts, rapid mood changes, persistent sadness, guilt, hopelessness and loss of interest in usual activities. WebMD and CNS Healthcare both stress that early intervention is important, while Bloom Psychology North Austin says postpartum psychosis in particular warrants immediate assessment because of the potential risk to mother and child.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
